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WCIRB Analyzes First-Year Impact of California’s New Drug Formulary

Effective January 1, 2018, the California Division of Workers’ Compensation adopted an evidence-based drug formulary intended to reduce frictional costs in the workers’ compensation system; restrict inappropriate prescribing, especially those that relate to opioids; and ensure that injured workers receive medically necessary medications in a timely manner.

The Workers’ Compensation Insurance Rating Bureau of California (WCIRB) reviewed the impact of the new drug formulary on prescribing patterns and pharmaceutical costs based on WCIRB pharmaceutical transaction information through the first year of implementation.

Key findings include:

  • The share of prescriptions of drugs not subject to prospective utilization review in accordance with the formulary increased by 41 percent compared to the pre-2018 level, while that of drugs subject to prospective utilization review declined by 18 percent.
  • The use of opioids, compounded drugs, physician-dispensed drugs and brand name drugs with generic alternatives dropped sharply in 2018, the first year of the formulary.
  • While pharmaceutical costs had been declining prior to the implementation of the formulary, the decline accelerated during 2018 suggestive of the drug formulary impact.

Read the entire WCIRB analysis brief at the following link:

WCIRB Research Forum Webinar

2018 Aggregate Medical Payment Trends and One-Year Impact of the Drug Formulary
Wednesday, September 4, 2019, 10:00 – 11:00 AM PT
The WCIRB’s Julia Zhang, Ph.D., Managing Director, Medical Analytics, and Elizabeth Sabiniano, Senior Medical Data Research Analyst, will host a webinar to discuss the California’s New Drug Formulary – One-Year Checkup brief as well as the 2018 California Workers’ Compensation Aggregate Medical Payment Trends report. 
Register Now>

For those unable to attend the live webinar, a recording will be posted in the Research section of the WCIRB website following the event.

Watch the following video highlighting a few findings in the report:

 

 

August 30, 2019